Individual
MRS. CRYSTAL LYNN BIRKENSTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
W293N3923 ROUND HILL CIR, PEWAUKEE, WI 53072-3159
(262) 369-1506
Mailing address
W293N3923 ROUND HILL CIR, PEWAUKEE, WI 53072-3159
(262) 369-1506
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1728024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40008900
—
WI
Enumeration date
04/16/2008
Last updated
04/16/2008
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